94 WASHINGTON SQUARE SOUTH - AFFIDAVITS Final Construction Control Document
To be submitted at completion of construction by a
Registered Design Professional
for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title:The Breakaway at Washington Square Date: AUGUST 31,2021 Permit No.
Property Address: 94 Washington Square South Salem,Ma. 01970
Project: Check(x)one or both as applicable:XX New construction XX Existing Construction
Project description:The scope of work for this project was the restoration of a historic mansion and to
construct a new two story addition to the existing one story structure that was added to the mansions.The
property was returned to residential use with a total of 18 dwelling units in the original mansion and new
addition.The associated improvements were made to the parking lot,site access,utilities and landscaping
I Peter Pitman MA Registration Number:8749 Expiration date:Aug 2021 ,am a registered design professional,
and I have prepared or directly supervised the preparation of all design plans,computations and specifications
concerning:
XX Architectural Structural Mechanical
Fire Protection Electrical Other:Describe
for the above named project. I, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis.To the best of my knowledge,information, and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee:
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet" or
electronic signature and seal: -
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f
BOSTON
TkOF-
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Phone number:978-744-8982 Email:pfpitman@juno.com •w�„�
Building Official Use Only
Building Official Name: Permit No.: Date:
P`tN OFiygs
Final Construction Control Document
To be submitted at completion of construction by a u ARE
Registered Design Professionals g
o,,
r for work per the ninth edition of the �s"SI rvnt
Y
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: The Breakaway at Salem Common Date:08.18.2021 Permit No.
Property Address: 94 Washington Square, Salem, MA 01970
Project: Check(x) one or both as applicable: X New construction Existing Construction
Project description: Multi-family redevelopment.
This project was installed in accordance with NFPA-13.
1 Michael Denommee MA Registration Number: 49888 Expiration date: 06/30/22 am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Architectural Structural Mechanical
X Fire Protection Electrical Other:
for the above named project. I, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis. To the best of my knowledge, information,and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee: Subject to the Completion of the Punch List Report
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet" or
electronic signature and seal:
Phone number:(978) 486-4301 Email:info@blwengineers.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 01 01 2018
& N OFMgs9
Final Construction Control DocumentQ� scyG
To be submitted at completion of construction by a :i
' Registered Design Professional 'F Q.
for work per the ninth edition of the wnt
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: _The Breakaway_ at Salem Common _ Date:08.18.2021 Permit No.
Property Address: 94 Washington Square, Salem, MA 01970
Project: Check(x) one or both as applicable: X New construction Existing Construction
Project description: Multi-family redevelopment.
I Michael Denommee MA Registration Number: 49888 Expiration date: 06/30/22 , am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Architectural Structural X Mechanical
Fire Protection Electrical X Other: Plumbing
for the above named project. I, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee: Subject to the Completion of the Punch List Report
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet" or
electronic signature and seal:
Phone number:(978) 486-4301 Email:info@blwengineers.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 01 O1 2018
� w oF�s�o
Final Construction Control Document �� Jo'IN C. ti
PIER.A
To be submitted at completion of construction by aca ELL
0° 1
' Registered Design Professional a T w�
for work per the ninth edition of the o
J
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: The Breakaway at Salem Common Date: 08.18.2021 Permit No.
Property Address: _ 94 Washington Square, Salem, MA 01970
Project: Check (x) one or both as applicable: X New construction Existing Construction
Project description: Multi-family redevelopment.
This project was installed in accordance with NFPA-72.
I John C. Pierga MA Registration Number: 48291 Expiration date: 06/30/22 , am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
Architectural Structural Mechanical
Fire Protection X Electrical X Other: Fire Alarm
for the above named project. 1, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis. To the best of my knowledge, information, and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee: Subject to the Completion of the Punch List Report
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet" or
electronic signature and seal:
Phone number: 978 486-4301 Email:info@blwengineers.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 01 012019
Df Massachusetts
"The Construction Testing People' -Page 1
5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax)
IFC FIRESTOPPING INSPECTION Report Date 11-16-2020
Report No. 3
Distribution Copy Job Number
23029
Project 94 Washington Square East, Salem, MA
The Breakaway of Salem Commons
Contractor T. Berube Contracting Co., Inc.
WEATHER:
TIME: 3: 00 AM
CONTACT:Mike
SUMMARY:
Attached is the IFC firestopping inspection report prepared by UTS inspector Eric McFadden for the
above project.
GENERAL REMARKS: IFC Firestopping Inspection.
Inspector Premium Travel
Name Time I Hours Time
Eric McFadden No 4.00 1 Hr(s)
REVIEWED BY: William P_ Crabtree
"RC-1
Our reports are available in PDF form via email. Please email us at reports@utsofmass.com for more information.
cc: T. Berube Contracting Co., Inc Mike Pydynkowski
Mcbrie Laura Bates
Mcbrie Mike Perham
T. Berube, Inc Mike Pydynkowski
UTS of Massachusetts, Inc. Page 3
5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax)
Report Date 11-16-2020
Report No. 3
Job Number 23029
Project 94 Washington Square East, Salem, MA
Attachment The Breakaway of Salem Commons
Page 2 of 5
Basement Level:Units 001&002
The following previous de icieneies were now found to be properly tmis LOW&
Basement Level is now COMPLETE
Basement:
Unit 1:
No Deficient Items
Unit 002:
%"CPVC @ Bath(seal fell out)
'/2"Copper Tubing @ Bath-top plate
Level 1:
Level I is now COMPLETE
Unit 103:
2"PVC(2)@ CMU wall(penetrates to Level 2)
%11 CPVCv(2)@ CMU wall(penetrates to Level 2)
Unit 104:
2"PVC(2)@ Entrance-right to Corridor
Unit 105:
MC(1)@ Entrance Closet-right-floor
2"PVC @ Living Closet-floor
Unit 1
Romex(2)@ Top of Stair Closet-floor
Hole @ Bath to Corridor-Repair
2"PVC @ Bath(outside comer)-floor
Unit 107:
2"PVC @ Top of Stair Closet-top plate/floor
2"PVC @ Kitchen Demising-floor
2"PVC @ Bath-floor
%"CPVC(2)@ Bath-floor
UTS of Massachusetts, Inc. Page 5
5 Richardson Lane,Stoneham,MA 02180 781-438-7755(Voice)781-438-6216(Fax)
Report Date 11-16-2020
Report No. 3
Job Number 23029
Project 94 Washington Square East, Salem, MA
Attachment The Breakaway of Salem Commons
Page 4 of 5
Level
The following deft iencies were found and witnessed being properlyfreStopped
Level 3 is now COMPLETE
Unit 301
MC(1)@ Bath to Corridor
1"Sprinkler @ Bath to Corridor
1"PVC @ Bath to Corridor
Unit 303
No Deficient Items
Unit 304
No Deficient Items
Final Construction Control Document
To be submitted at completion of construction by a
Registered Design Professional
M
for work per the ninth edition of the
Massachusetts State Building Code, 780 CMR, Section 107
Project Title:The Breakaway at Salem Common Date:September 18,2020 Permit No.
Property Address: 94 Washington Square,Salem,MA
Project: Check (x) one or both as applicable: I X New construction X Existing Construction
Project description:
I, Michael Perham, MA Registration Number: 41143 Expiration date: 06/30/2022, am a registered design
professional, and I have prepared or directly supervised the preparation of all design plans,computations and
specifications concerning:
Architectural X Structural Mechanical
Fire Protection Electrical Other: Describe
for the above named project. I, or my designee, have performed the necessary professional services and was
present at the construction site on a regular and periodic basis. To the best of my knowledge,information, and
belief the work proceeded in accordance with the requirements of 780 CMR and the design documents approved
as part of the building permit and that I or my designee:
1. Have reviewed,for conformance to this code and the design concept,shop drawings,samples and other
submittals by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17,as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with
the progress and quality of the work and to determine if the work was performed in a manner consistent
with the construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CMR 107.
Enter in the space to the right a"wet" or IN OF Mqs
electronic signature and seal: ���`'P s9�y
�o MICHAEL L GN
PERHAM
STRUCTURAL
No.41143
-off 9
Phone number:978-646-0097 Email:mperham@mcbrie.com
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 01 01 2018